Sponsored by

Liesl Tesch

A truly inspirational Australian

WHEN: WEDNESDAY 8 March

5.30pm for 6.00pm

COST: $55.00 gst inc registration

Includes:

ü  Appetisers, main meal and a selection of desserts

ü  keynote speaker – extended session

ü  lots of fun

ü  prizes

ü  WIEL touches

PAYMENT INFORMATION:

Registration and payment must be received by FRIDAY 3 March 2017

Please note that payment MUST be received with registration form

OR clearly indicated on the registration form.

Please - No payment on the night and no late registration.

All questions should be directed to Janelle by email,

For special dietary requirements please email Janelle by Friday 3 March 2017

CANCELLATION POLICY - Any cancellations must be made by Friday 24 February 2017 to Janelle by email - if a refund is required. Full payment must be made if notification is made after this date or if no notification is received. No refunds will be made for cancellations after this date. A substitute may attend in the place of the original registration. WIEL reserves the right to cancel or reschedule events or change advertised speakers.

This is the page you need to send to register!

REGISTRATION FORM and TAX INVOICE

CENTRAL COAST WIEL DINNER Wednesday 8 March, 2017

Please email this form and indicate payment method

to

with cc

Women In Educational Leadership WIEL ABN 37 726 093 954

12 Oxley St

LAKE CATHIE 2445

Name……………………………………………………...………DATE………………………………

wORKPLACE………………………………………………………………..…………..

EMAIL CONTACT ……………………………………………………… (@det.nsw.edu.au email is preferred)

Please indicate clearly the one payment method you are using

Direct Deposit or On-Line Credit Card are the preferred payment methods.

o PERSONAL DIRECT DEPOSIT

Please email this registration form to Rose.Pelley @det.nsw.edu.au and directly deposit $55.00 to ANZ Bank Wauchope BSB 012703 Account Number 483381169 Account Name – Women In Educational Leadership

IMPORTANT – for the REFERENCE - please identify yourself by using CC (Central Coast Network)

and your name so that we can match your deposit with your form. eg CC/Lissa Tardiani.

If you don’t do this we do not know who has made the deposit.

o CREDIT CARD - please complete form on page 4 and email to

o PERSONAL CHEQUE ($55.00 inc gst)

Registration forms with cheque payment should be posted Rose Pelley (see above)

Cheques must be made out to Women In Educational Leadership

o SCHOOL CHEQUE /DIRECT DEPOSIT by SCHOOL eg for 229 schools

Send this form to Rose Pelley (see above). WIEL SUPPLIER NUMBER 100017080 (for 229 schools)

Principal's signature authorising payment ………………………………………………………

CREDIT CARD PAYMENT FORM

CENTRAL COAST WIEL DINNER 8 March 2017

PLEASE SEND DIRECTLY TO – ROSE PELLEY WIEL STATE TREASURER

Email -

Post – Women in Educational Leadership

12 Oxley St

LAKE CATHIE 2445

Credit Card Payment Advice

Registration for name/names ………………………………………………………………………...

Workplace…………………………………………………………………………

Payment for CENTRAL COAST WIEL DINNER MEETING Wednesday 8 March 2017

Visa o Mastercard o

o  $55.00 registration

Account No: Security Code:

Name on Card: ………………………………………………………………. (Block letters)

Expiry Date: ……………………………

Address: ……………………………………………………………………………………………………….…

Phone: …………………………………

Amount to be debited: $......

Signed: ……………………………………………………………. Date: …………………………

Please note: No information is kept after payment is finalised.

A receipt will be sent to verify payment

Please email this form to:

SCHOOL NAME: ______

STAFF NAME / EMAIL ADDRESS / COST (inc GST)
@det.nsw.edu.au / $55
TOTAL

Please indicate payment method for yourself or school.

o PERSONAL DIRECT DEPOSIT

Please email this registration form to and directly deposit $55.00 to:

ANZ Bank Wauchope: BSB 012703 Account Number: 483381169 Account Name – Women in Educational Leadership Reference – WC/Your name

o CREDIT CARD - please complete form on page 4 and email this form to

o PERSONAL CHEQUE ($55.00)

Registration form with cheque payment should be posted to Rose Pelley (see address above).

Cheques must be made out to Women in Educational Leadership

o SCHOOL CHEQUE

Send this form to Rose Pelley (see address above).

School cheques must be made out to Women in Educational Leadership

o DIRECT DEPOSIT by SCHOOL

WIEL SUPPLIER NUMBER 100017080 (for 229 schools)

ANZ Bank Wauchope: BSB 012703 Account Number: 483381169 Account Name – Women In Educational Leadership